RT Journal
A1 Fiore JP
T1 REversal of cimetidine-induced stupor by physostigmine
JF JAMA
JO JAMA
YR 1979
FD September 14
VO 242
IS 11
SP 1141
OP 1141
DO 10.1001/jama.1979.03300110015016
UL http://dx.doi.org/10.1001/jama.1979.03300110015016
AB To the Editor.—
In a recent article by Mogelnicki and associates (241:826, 1979) regarding the use of physostigmine in two patients to reverse a stupor that was apparently induced by the histamine H2 antagonist cimetidine, the authors note two possible explanations for the observed events: First, physostigmine was acting specifically to reverse an anticholinergic stupor caused by cimetidine. Cimetidine would be classified with a wide variety of other drugs known to produce the central anticholinergic syndrome, which is manifested by stupor in severe cases. If physostigmine was reversing a central anticholinergic stupor produced by cimetidine, presumably at H2 receptors in the CNS, the clinical manifestations of the anticholinergic syndrome in these two patients were unusual because the patients did not first manifest the usual initial mental changes associated with the central anticholinergic syndrome, such as delirium and agitation, before their conditions progressed to stupor.The second explanation of